Detectability of cerebral aneurysms and surrounding vessels by three-dimensional evaluation using helical scanning CT (HES-CT)

Helical scanning CT (HES-CT) is a new technique to enable high-speed volumetric data acquisition. We have applied HES-CT to the diagnosis of cerebral vascular diseases. In our experience, the relationship between the scanning parameters of HES-CT and image quality was complex and reciprocal, so that optimization of the parameters according to the clinical demands was essential. We compared HES-CT with conventional cerebral angiography to determine the detectability of the aneurysm and surrounding vessels, and sought the optimal parameters to delineate small vessels. All aneurysms were detected in multiplanar reconstruction (MPR) images. The smallest one was 3 x 4 mm. MPR images were found to have some advantages over conventional cerebral angiography in delineation of intracranial aneurysms: 1) scanning was over in a short time (30s), 2) the relationship between the aneurysm and surrounding vessels was easily recognized, 3) the diameter of the neck could be measured, because the neck of the aneurysm and parent artery could be imaged on the same plane without overlapping another vessel, 4) calcified lesions on the aneurysmal wall were detected, and 5) HES-CT was done safety without arterial puncture. However, the detectability of unknown aneurysm was less than the detectability of known aneurysm in MPR images. The 180 degrees interpolation algorithm and 1 mm slice were effective in detecting small vessels. However, vessels with a diameter less than 1 mm could not be detected by HES-CT. HES-CT was considered to be useful as a supplementary examination to conventional angiography for the diagnosis of intracranial aneurysms.